D-H Exec to Leave for Boston

Clinical Chief Arrived in 2012

Lebanon — A Dartmouth-Hitchcock executive hired last year to help the organization create a new vision for a sustainable health care system in the Twin States is leaving at the end of the year to take a job in Boston.

Gregg Meyer will step down Dec. 31 to join Partners HealthCare as its chief clinical officer.

He is leaving Dartmouth-Hitchcock after a little more than a year and a half, having started there in May 2012 in the newly created position of executive vice president for population health and chief clinical officer.

In an e-mail to staff last week, Dartmouth-Hitchcock President and CEO Jim Weinstein said Meyer “took on a very important role” at Dartmouth-Hitchcock and had been “unrelentingly committed to doing the right thing.”

“No matter where he is, he will continue to be our friend and a collaborator in making a difference for all patients, their families and the communities we serve,” Weinstein said in the e-mail. “I know from our conversations that these decisions are tough, but I respect Gregg deeply and understand that this decision is the right one for him and his family.”

In a telephone interview Monday, Meyer said the decision to leave was difficult because of the “really terrific things going on up here at D-H.”

However, the opportunity to address some of the challenges facing health care providers, and on a larger scale at Partners, convinced him to leave.

“I was given an extraordinary opportunity which I don’t think is going to come my way again,” Meyer said.

Meyer worked closely with Weinstein as Dartmouth-Hitchcock looked at new models for care and studied how the health care system could lower costs while improving quality.

One of his primary charges was to steer the organization under a model of population health, a concept in which providers concentrate on improving the health outcomes of a group of people, and look at some of the social, political and environmental factors that influence their well being.

At Partners, Meyer will oversee quality and safety, two issues that he said are “nearest and dearest to my heart,” as well as population health and information technology. He will begin his new job at the end of January.

In going back to Boston, Meyer is returning to familiar territory. He came to Dartmouth-Hitchcock from Harvard Medical School and Massachusetts General Hospital. Partners HealthCare is a non-profit health system founded in 1994 by Brigham and Women’s Hospital and Massachusetts General Hospital. It includes community and specialty hospitals, a managed care organization, a physician network, community health centers, home care and other health-related entities.

Partners is the largest private employer in Massachusetts, with approximately 60,000 employees, including physicians, nurses, scientists, and caregivers, according to the organization’s website.

Meyer said that during his time in the Upper Valley, Dartmouth-Hitchcock made significant progress toward improving efficiency and quality. It also began working on new payment models in health care. One initiative was establishing an accountable care organization, called OneCare Vermont, with Fletcher Allen Health Care in Burlington and which includes Vermont’s other hospitals.

A key part of the Affordable Care Act, accountable care organizations are aimed at reining in health care spending on Medicare patients while maintaining — maybe even improving — the quality of care. The health care providers in the ACOs then split the savings with Medicare.

Although ACOs can take different forms, the same basic principle applies to all: hospitals agree to take responsibility for the cost and quality of caring for a certain group of patients, no matter what.

Dartmouth-Hitchcock launched a “Pioneer ACO” in New Hampshire in January 2012 and this year rolled out OneCare.

“When I got here, the whole notion of doing an ACO in Vermont as part of Vermont health care reform wasn’t even a glimmer in our eye,” Meyer said. “It was not even something we’d thought of.”

Now Dartmouth-Hitchcock is considering expanding the ACO concept in Vermont, doubling or even tripling the number of patients served through that model over the coming year, he said. Other significant changes during Meyer’s tenure include partnership with Harvard Pilgrim and Elliot Health System in Manchester called “Elevate Health,” which aims to improve coordinating care for patients and lower insurance premiums.

“We’ve been able to accomplish I think a great deal over the last almost two years now,” Meyer said.

But he was also aware of the difficulties that accompany change, particularly if it came too quickly.

In a Dartmouth-Hitchcock video released shortly after his hiring, Meyer said he hoped to spend most of his time “listening” to people around Dartmouth-Hitchcock to find out what kind of changes it was prepared to make.

“You can have the best interventions and the best intentions and if the soil isn’t ready for that seed, if the culture isn’t ready, if you don’t understand the environment, you can have a spectacular failure,” Meyer said in the video. “And there’s nothing worse (than) failing with a good idea. Because what you do is you poison the well. And that you don’t have the opportunity to go back and try it again.”

No one has been hired to replace Meyer, according to Dartmouth-Hitchcock spokesman Rick Adams. It’s not even certain whether the job Meyer is leaving will continue to exist. Meyer said his departure could be an opportunity for Dartmouth-Hitchcock to restructure leadership.

“I think Dr. Weinstein will look at this as an opportunity to think about how the leadership needs to be structured moving forward,” Meyer said.